Case Report: The Laboratory Examination and Viral Sequencing Analysis of the First Novel Influenza A (H1N1) Patient with Sever Complication in Taiwan

Ji-Rong Yang

2009 Vol.25 NO.9

Correspondence Author： Ji-Rong Yang

Abstract：

On July 17, 2009, the Centers for Disease Control in Taiwan (Taiwan CDC) confirmed the first case of severe patient infected by novel influenza A(H1N1) virus. The patient is a 34-year-old male without underlying cardiopulmonary disease or travel history. He came to hospital because of cough, sore throat and dyspnea. His symptoms became worse despite treatment and led into multiple organ failure. Then he was sent to intensive care unit for further treatment. The Respiratory Virus Laboratory received the information and tested the throat swab and sputum from this patient. Both specimens revealed positive for novel influenza A(H1N1) virus by real time RT-PCR. Sequencing analysis of HA, NA, and M gene of this virus isolate, discovered S31N mutation in HA gene. This strain was resistant to amatadine and sensitive to oseltamivir because the 274th amino acid of NA gene was still Histidine. After comparing with the virus gene sequences from other countries, this virus contained D225G change. The evolutionary analysis showed all novel influenza isolates at Taiwan came from the same origin. Because this virus might come from community, correct and rapid test with virus surveillance and anti-viral medication in time would allow monitoring the changes of novel influenza virus in the future, furthermore, prevent the severe case and mortality from happening.
Keywords: H1N1 pandemic influenza, real-time RT-PCR, antiviral drug resistance, phylogenetic analysis